Provider Demographics
NPI:1932497187
Name:CARDIOVASCULAR SOLUTIONS INSTITUTE LLC
Entity Type:Organization
Organization Name:CARDIOVASCULAR SOLUTIONS INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINO
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-747-8789
Mailing Address - Street 1:2210 61ST ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-5527
Mailing Address - Country:US
Mailing Address - Phone:941-747-8789
Mailing Address - Fax:941-747-8711
Practice Address - Street 1:2210 61ST ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5527
Practice Address - Country:US
Practice Address - Phone:941-747-8789
Practice Address - Fax:941-747-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76343207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME76343OtherMEDICAL LICENSE